不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应的差异

doi:10.11852/zgetbjzz2019-0457

摘要/Abstract

摘要： 目的分析不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应的差异,为儿童感染的治疗供科学依据。方法以2016年10月-2018年9月攀枝花市第二人民医院儿科门诊HAdV呼吸道感染的儿童186名为研究对象。分离、培养呼吸道腺病毒,通过hexon、fiber PCR确定腺病毒的类型和种类,并分析不同亚群腺病毒的时间、性别、年龄分布,通过试剂盒测定血清中细胞因子水平。结果 175名(94.09%)患者鉴别出HAdV类型,C亚群(2型、1型、5型、6型)最常见,为34.86%。B亚群病毒在夏季和初秋的发病率较高,C亚群病毒全年流行,E亚群病毒仅在早春流行。C亚群病毒主要在1岁左右儿童中检出,而B、E亚群病毒主要在较大儿童中检出(F=12.074,P=0.003)。C亚群腺病毒感染患者的WBC计数显著高于B亚群和E亚群感染患者(F=5.215,P<0.05)。此外,血清中共检测到11种细胞因子,C亚群感染患者中G-CSF、IFN-γ、IL-6、TNF-α、MCP-1、MIP-1β、Eotaxin7种细胞因子水平显著升高(F＝8.236、4.968、7.130、18.757、7.155、6.077、5.070,P<0.05),IL-10水平显著降低(F＝6.362,P<0.05)。结论不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应方面存在显著差异,其中C亚群腺病毒引起的炎症反应最强烈。

关键词: 人腺病毒, 细胞因子, 流性特征, 炎症反应

Abstract: Objective To analyze the epidemic characteristics and inflammatory responseof human adenovirus (HAdVs) infected children in different subgroups,in order to provide scientific reference for the treatment of respiratory infections in children. Methods A total of 186 children with HAdV respiratory infections in Pediatric Outpatient Department were enrolled in this study from October 2016 to September 2018.The respiratory adenovirus was isolated and cultured.The type of adenovirus was determined by hexon and fiber PCR.The time,sex and age distribution of different subgroups of adenovirus were analyzed.The serum cytokine levels were determined by kit. Results HAdV type was identified in 175(94.09%) patients,and C subgroup(type 2,1,5 and 6) was the most common (34.86%).The subgroup B virus had a high incidence in summer and early autumn,and the C subgroup virus was prevalent throughout the year,while the E subgroup virus was only prevalent in early spring.The C subgroup virus was mainly detected in children around 1 year old,while the B subgroup and E subgroup viruswere mainly detected in older children(F=12.074,P=0.003).The WBC count of patients with subgroup C adenovirus infection was significantly higher than that of patients with B subgroup and E subgroup (F=5.215,P<0.05).In addition,11 types of cytokines were detected in serum,and the levels of 7 types of cytokines,such as G-CSF,IFN-γ,IL-6,TNF-α,MCP-1,MIP-1β and Eotaxin,significantly elevatedin patients infected with C subgroup (F=8.236,4.968,7.130,18.757,7.155,6.077,5.070,P<0.05).However,the IL-10 level was significantly decreased in patients infected with C subgroup (F=6.362,P<0.05). Conclusions There are significant differences on the epidemic characteristics and inflammatory response in different subgroups of children with respiratory adenovirus infection.Moreover,the inflammatory response caused by adenovirus C is the strongest.

Key words: human adenovirus, cytokines, epidemic characteristics, inflammatory response

中图分类号:

R725.6

李薇. 不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应的差异[J]. 中国儿童保健杂志, 2019, 27(9): 1019-1022.

LI Wei. Differences on epidemic characteristics and inflammatory response in different subgroups of respiratory adenovirus infected children[J]. journal1, 2019, 27(9): 1019-1022.

参考文献

[1] Natchiar SK,Venkataraman S,Mullen TM,et al.Revised cry stal structure of human adenovirus reveals the limits on protein IX quasi-equivalence and on analyzing large macromolecular complexes[J].J Mol Biol,2018,430(21):4132-4141.
[2] Ghebremedhin B.Human adenovirus:Viral pathogen with increasing impor tance [J].Eur J Microbio L,2014,4(1):26-33.
[3] 赵素慧.呼吸道腺病毒的分离、鉴定及分子流行病学研究[D].广州:南方医科大学,2013.
[4] Lee WJ,Jung HD,Cheong HM,et al.Molecular epidemiology of a post-influenza pandemic outbreak of acute respiratory infections in Korea caused by human adenovirus type 3[J].J Med Virol,2015,87(1):10-17.
[5] Kaneko H,Tatsuo S,Koki A,et al.Epidemiological and virological features of epidemic keratoconjunctivitis due to new human adenovirus type 54 in Japan[J].Brit J Ophthalmol,2011,95(1):32-36.
[6] Li Y,Zhou W,Zhao Y,et al.Molecular typing and epidemiology profiles of human adenovirus infection among paediatric patients with severe acute respiratory infection in China [J].PloS One,2015,10(4):23-27.
[7] 杨金峰,商蕾,董妥,等.人7型腺病毒的分离与鉴定[J].哈尔滨医科大学学报,2014,48(5):353-357.
[8] 王瑞琨,商蕾,王迎晨,等.呼吸道感染人腺病毒的分离培养和型别鉴定[J].哈尔滨医科大学学报,2013,47(5):385-387,482.
[9] Banik U,Adhikary AK,Suzuki E,et al.Multiplex PCR assay for rapid identification of oculopathogenic adenoviruses by amplification of the fiber and hexon genes [J].J Clin Microbiol,2005,43(3),1064-1068.
[10] 张艳妮,熊英,龚甜,等.江西省2010-2014年呼吸道感染腺病毒基因特征分析[J].实验与检验医学,2017,35(5):650-653.
[11] 崔奇,董妥,王迎晨,等.人3型腺病毒六邻体基底区重组蛋白的克隆表达和纯化[J].哈尔滨医科大学学报,2017,51(3):191-194.
[12] Binder AM,Biggs HM,Haynes AK,et al.Human adenovirus surveillance-united States,2003-2016[J].MMWR-Morbid Mortal W,2017,66(39):1039-1045.
[13] 李红,毛乃颖,余鹏博,等.2013～2014年我国4省急性呼吸道感染人腺病毒4型的基因特征分析[J].病毒学报,2018,34(6):850-859.
[14] Rojas LJ,Jaramillo CA,Mojica MF,et al.Molecular typing of adenovirus circulating in a Colombian paediatric population with acute respiratory infection [J].Epidemiol Infect,2012,140(5):818-822.
[15] Wang YF,Shen FC,Kuo PH,et al.Molecular epidemiology and clinical manifestations of adenovirus respiratory infections in Taiwanese children [J].Medicine,2016,95(18):1025-1034.